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Slide 17

The table shows actual reduction in adverse events in moving patients from worse to best providers based on an imperfect measure.

POA Sample

Number of Adverse Events

Percent

Best 20%

Worse 20%

Difference

None

283

5,169

4,886

91.7%

10%

275

5,213

4,938

92.7%

20%

267

5,245

4,977

93.4%

30%

270

5,287

5,017

94.2%

40%

259

5,323

5,063

95.1%

50%

261

5,374

5,114

96.0%

60%

244

5,377

5,133

96.4%

70%

240

5,427

5,187

97.4%

80%

229

5,469

5,241

98.4%

90%

216

5,516

5,300

99.5%

All

215

5,542

5,327

100.0%

Slide 18

Risk Aversion

A consumer may rationally select a provider with worse measured quality:

If the consumer is risk averse and prefers a more certain outcome over the greater risk of a worse outcome.

If the consumer has external information about the provider that reduces uncertainty.

Slide 19

Risk Aversion

A consumer may rationally select a provider with worse measured quality:

If the consumer is risk averse and prefers a more certain outcome over the greater risk of a worse outcome.

If the consumer has other information about the provider that reduces uncertainty.

Slide 20

Risk Aversion

Image: Line graph shows Iatrogenic Pneumothorax (PSI #06) rates for Hospital B EOL vs. Hospital A EOL. Hospital A has a sharp spike, while Hospital B is an even bell curve.

Slide 21

Conclusions

Use expected value of information (EVI) to quantify the benefit of adding enhanced data, collecting data over time.

Largest marginal gain in EVI may come from:

Initial measurement

Systemic relationships

Smallest marginal gain in EVI may come

Subsequent measurement

Provider specific measurement

Slide 22

Conclusions

Target data collection to the measures, consumers and providers with highest marginal EVI.

Give consumers information about uncertainty to allow them to incorporate preferences about risk and external information.

Slide 23

Questions?

Image: An illustration of a microphone is shown.

Current as of December 2010

Internet Citation: How Good is Good Enough? A Case Study with Present on Admission (Text Version).
December 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/news/events/conference/2010/geppert/index.html

The information on this page is archived and provided for reference purposes only.